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What type of burn injures pose the greatest risk for thermal burns to the eye? Pg.1312

Explosions and flash burns

Ultraviolet light can cause what type of damage to the eye? Pg.1312

Can cause corneal damage ranging in severity from mild to extensive.

What are three types of Ultraviolet light burns? Pg.1312

snowblindness, welder’s arc burn or flash burn

What is a penetrating injury to the eye? Pg.1312

- the layers of the eye spontaneously re-approximate after entry of sharp-pointed object or small missile into the globe.

What is a perforating injury to the eye? Pg.1312

layers of the eye do not spontaneously re-approximate resulting in rupture of the globe and potential loss of ocular contents. A perforating eye involves an entrance and exit wound both of which are caused by the same source.

What are some concerns with a penetrating injury when assessing a client? Pg.1312

May be hidden because of tissue swelling, May be missed if client has other significant injuries, If eyelid is lacerated/puncture wound inspect eye tissue for damage

Caused by a rupture of a blood vessel in the conjunctiva, appears as a bright area of erythema, no pain/treatment, reabsorbs in 2-3weeks

What is a hyphema? Pg.1312

bleeding into the anterior chamber of the eye, Client complains of eye pain, experiencing decreased visual acuity and seeing a reddish tint. Blood is visible in the anterior chamber.

What is enophthalmos? And when do you see it? Pg.1312

Eye appears sunken and has limited movement, Can occur after an orbital fracture

What happens to the eye during an orbital fracture? Pg.1312

Ethmoid bone on the orbital floor is the most likely site to be fractured. Orbital contents including fat, muscles, and the eye itself may herniate thru the fracture into the underlying maxillary sinus.

What happens when a retina detaches? Pg.1312

Separation of the retina or sensory portion of the eye from the choroid, the pigment vascular layer. It may occur after trauma but usually occurs spontaneously.

What are some risk factors related to retinal detachment? Pg.1312

Aging is a common risk factor, as are myopia, glaucoma, trauma, previous retinal detachment and aphakia, absence of the lens

Most migrant workers don’t have jobs that provide worker’s compensation coverage. B/c of a limited number of clinics that serve this population, many injuries go both unreported and untreated

Table. Focus on Diversity & Culture. What type of exposures are the migrant farm workers at risk for? Pg.1312

chemicals, machinery, tools, and airborne soil and particulates.

Table. Clinical Manifestations and Therapies: Eye Injuries. What are the clinical manifestations for detached retina? Pg.1314

floaters: irregular dark lines or spots on the field of vision, flashes of light, blurred vision, progressive deterioration of vision, sensation of a curtain or veil being drawn across the field of vision, if macula is involved, loss of central vision

Table. Clinical Manifestations and Therapies: Eye Injuries. What are the clinical therapies for detached retina? Pg.1314

slit-lamp is a high-intensity light source combined with a low-power microscope can be focused to shine a blue light in a thin beam, used in conjunction with fluorescein stain, Fluorescein is orange/yellow in color appears if defect on the cornea

What other test can be done for the eye? Pg.1314

Facial x-rays & CT scan used to identify orbital fractures or foreign bodies in the globe. Ultrasonography used to detect a detached retina or vitreous hemorrhage

What treatments of the eye would not need surgical intervention? Pg.1314

What surgical interventions maybe necessary due to a severe chemical burn? Pg.1314

debridement, tissue grafting, or even corneal transplant

What is considered a medical emergency in order to preserve vision? Pg.1314

Retinal detachment is medical emergency; early diagnosis and treatment are important to preserve vision.

What are the three surgical treatments for retinal detachment? Pg. 1314

Cryotherapy, Scleral buckling, Pneumatic retinopexy

Describe Cryotherapy and how it is used to correct retinal detachment? Pg. 1314

uses a cooled probe or laser photocoagulation may be used to create an area of inflammation and adhesion to “weld” the layers together

Describe Scleral buckling and how it is used to correct retinal detachment? Pg. 1314

Scleral buckling during which an indentation or fold is surgically created in sclera to restore contact between retina and choroid. Contact is maintained with a local implant on the sclera or an encircling strap or buckle.

Describe Pneumatic retinopexy and how it is used to correct retinal detachment? Pg. 1314

air is injected into the vitreous cavity. Pt is positioned so air bubbles pushes the detached portion of the retina into contact with the choroid

What steps will the nurse take in order to protect the eye from further injury when penetration or perforation is suspected? Pg.1316

Do not place any pressure on the eye itself, cover gently with sterile gauze or eye pad, if object is embedded or sticking out of eye do not attempt to remove, object should be immobilized with metal eye shield, patch unaffected eye to decrease movement

What interventions and instruction would an RN offer to a client with a blunt trauma to the eye? Pg.1316

Intervention: best rest in Semi-fowler's position, use eye shield to prevent further damage, unaffected eye should be patched to reduce movement. Instruction: if healing has not occurred in 1-2weeks FU